优化炎调方治疗脓毒性休克(热毒内盛证)的临床研究

Clinical Study of Youhua Yantiao Granules in the Treatment of Septic Shock with the Pattern of Internal Exuberance of Heat-toxin

目的观察优化炎调方治疗脓毒性休克(热毒内盛证)患者的效果并探寻其作用机制。方法65例患者随机分为试验组33例与对照组32例。对照组给予西医基础治疗加安慰剂颗粒鼻饲或口服,试验组给予西医基础治疗加优化炎调方颗粒剂鼻饲或口服,疗程均为14 d。分析比较评价两组28 d生存率、急性生理与慢性健康(APACHEⅡ)评分、序贯器官功能衰竭(SOFA)评分、血常规[白细胞计数(WBC)、中性粒细胞百分比(N%)、C反应蛋白(CRP)]及炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、降钙素原(PCT)、乳酸(Lac)、(HBP)]等。结果试验组患者第28天生存率为78.79%,高于对照组的43.75%(P<0.05),危险度RR=2.652。试验组治疗14 d后SOFA和APACHEⅡ评分与治疗前比较均下降(均P<0.05),而对照组SOFA和APACHEⅡ评分治疗前后比较,差别不大(均P>0.05),且试验组SOFA和APACHEⅡ评分均低于对照组(均P<0.05),治疗第14天后,试验组WBC、N%、CRP、Lac、PCT、TNF-α、IL-6、IL-8、HBP较治疗前均降低(均P<0.05),且试验组的各指标水平均低于对照组(均P<0.05)。结论优化炎调方能够提高脓毒性休克(热毒内盛证)患者28 d生存率,改善患者炎症指标,具有较好临床疗效。

Objective:To observe the effect of Youhua Yantiao Granules on shock patients with the pattern of internal exuberance of heat-toxin and explore its mechanism.Methods:65 patients were randomly divided into an experimental group and a control group.Among them,33 patients were included in the experimental group,32 patients were included in the control group.The control group received basic western medicine treatment+nasal feeding or oral administration of placebo granules,while the experimental group received basic western medicine treatment+nasal feeding or oral administration of Youhua Yantiao Granules.The treatment courses were all 14 days:The improvement of the 28 day survival rate,APACHE I score,SOFA score,blood routine(WBC,N%,CRP),and inflammatory factors(TNF-α,IL-6,IL-8,PCT,lactate,HBP)were analyzed and evaluated.Results:The 28 day survival rate of patients in the experimental group was 78.79%,which was higher than 43.75%in the control group(P<0.05),and the RR=2.652.There was no significant difference between the two groups in terms of SOFA score and APACHE II score,blood routine(WBC,N%,CRP)and biomarkers(TNF-α,IL-6,IL-8,PCT,Lac,HBP)before treatment(all P>0.05).After 14 days of treatment,the SOFA and APACHE II scores in the ex-perimental group decreased compared with those before treatment(all P<0.05),while the SOFA and APACHE II scores in the control group were not significantly different before and after treatment(both P>0.05),and the scores of SOFA and APACHE I in the experimental group were lower than those in the control group(all P<0.05);after the 14th day of treatment,the WBC,N%,CRP,Lac,PCT,TNF-α,IL-6,IL-8 and HBP in the experi-mental group were lower than those before treatment(all P<0.05),and the levels of each index in the experimen-tal group were lower than those in the control group(all P<0.05).Conclusion:Youhua Yantiao Granules can im-prove the 28 day survival rate of patients with septic shock,improve inflammation indicators,and have good clinical efficacy,which can be further promoted and studied.